ABCD - Western Australian Family Support Networks€¦ · 3 The Armadale Family Support Network 15 3.1 The Armadale district 15 3.2 Overview of the Armadale Family Support Network

ABCD

Evaluation of the Armadale Family Support Network

Final Evaluation Report

Department for Child Protection and Family Support Western Australia June 2013

Western Australian Department for Child Protection and Family SupportEvaluation of the Armadale Family Support Network

Final Evaluation ReportJune 2013

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affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.

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Contents

Executive summary 1

1 Introduction 4 1.1 Evaluation purpose and scope 4 1.2 Evaluation methodology 4 1.3 Evaluation design 5 1.4 Structure of the report 7

2 The policy and operating model underpinning the Family Support Network 8

2.1 Policy context 8 2.2 Benefits of an integrated and coordinated approach 11 2.3 Avoided costs 13 2.4 Summary 14

3 The Armadale Family Support Network 15 3.1 The Armadale district 15 3.2 Overview of the Armadale Family Support Network 16 3.3 AFSN client characteristics 18 3.4 Activity levels of the AFSN – the first 12 months 20 3.5 Referral source and type 20 3.6 Summary 23

4 Implementation of the AFSN 24 4.1 Implementation overview 24 4.2 Future considerations for future FSN implementation 27

5 Outcomes for clients 28 5.1 Completed cases 28 5.2 Primary issue of concern 29 5.3 Improvements in family capacity to care / family functioning 32 5.4 Summary 34

6 Impact on CPFS 36 6.1 The AFSN and child protection 36 6.2 Stabilisation/reduction in child protection activity 38 6.3 Summary 45

7 Resourcing the AFSN 46



ii © 2013 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms




7.1 Overview of analytical approach 46 7.2 Program cost analysis – results 48 7.3 Quantitative benefits analysis – results 49 7.4 Qualitative benefits analysis 54 7.5 Economic analysis – overall conclusions 55 7.6 Sensitivity testing 56

A Stakeholders 58

DISCLAIMER

Inherent Limitations

This report has been prepared as outlined in the Scope Section. The services provided in connection with this engagement comprise an advisory engagement, which is not subject to assurance or other standards issued by the Australian Auditing and Assurance Standards Board and, consequently, no opinions or conclusions intended to convey assurance have been expressed.

No warranty of completeness, accuracy or reliability is given in relation to the statements and representations made by, and the information and documentation provided by, the stakeholders consulted as part of the process.

KPMG has indicated within this report the sources of the information provided. We have not sought to independently verify those sources unless otherwise noted within the report.

KPMG is under no obligation in any circumstance to update this report, in either oral or written form, for events occurring after the report has been issued in final form.

The findings in this report have been formed on the above basis.

Third Party Reliance

This report is solely for the purpose set out in the Scope Section and for the Department for Child Protection and Family Support information, and is not to be used for any other purpose or distributed to any other party without KPMG’s prior written consent.

This report has been prepared at the request of the Department for Child Protection and Family Support in accordance with the terms of KPMG’s engagement letter/contract dated 9 December 2012. Other than our responsibility to the Department for Child Protection and Family Support, neither KPMG nor any member or employee of KPMG undertakes responsibility arising in any way from reliance placed by a third party on this report. Any reliance placed is that party’s sole responsibility.



iii © 2013 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms




Acronyms and abbreviations

AFSN Armadale Family Support Network

ASO Assessment Support Officer

CEP common entry point

CPFS Department for Child Protection and Family Support

FSN Family Support Network

GJCAC George Jones Child Advocacy Centre

IT Information Technology

MOU Memorandum of Understanding

Parkerville Parkerville Children and Youth Care (Inc)

State Plan Secondary Family Support State Plan 2010-2013

SWA Safety and Wellbeing Assessment

WA Western Australia



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© 2013 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.



Executive summary The Department for Child Protection and Family Support (CPFS) has been implementing a large-scale reform agenda aimed at integrating family support services across Western Australia (WA). The establishment of Secondary Family Support Networks (FSNs) is critical to achieving this integration. The Armadale Family Support Network (the AFSN) is the first Family Support Network (FSN) to be implemented in WA. It is located in the Armadale district and is led by Parkerville Children and Youth Care Inc (Parkerville).

The AFSN operates with partner agencies who are providers of secondary family support services. Partner agencies have signed memoranda of understanding (MOU) which bind them to an agreed approach to service provision. Currently, the following organisations are AFSN partner agencies:

• Armadale Youth Resources

• Centrecare

• Communicare

• Coolabaroo

• Department for Child Protection and Family Support, Armadale District

• Drug ARM WA

• Minnawarra House

• Mission Australia

• Relationships Australia

• Ruah Community Services

• Starick Services

• Wanslea Family Services.

The Department for Child Protection and Family Support (the Department) provides annual funding of $458,700, over three years, to Parkerville Children and Youth Care as the lead agency for the AFSN. Funding enables the operation of the Common Entry Point; the CEP team comprises an Alliance Manager and two Assessment and Support Officers. The Department also provides one full time equivalent senior child protection worker, based at the CEP. A further $1 million per annum is provided to help build the capacity of AFSN partner agencies, including flexible brokerage funding.

Progress to date

Overall, the AFSN has made good progress in a number of areas, including:

• alignment to original intent and operating model.

• providing an accessible and visible point of contact in the local Armadale District, with a proportion of self-referrals and good links with local schools and health services.



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• maintaining an effective and efficient response to demand, particularly as the activity levels have been consistent across the 12-month period, although the common entry point (CEP) has highlighted the need for flexibility as the resource levels have increased in response to increasing demand.

• early evidence of positive outcomes for vulnerable children and their families.

The AFSN in the first 12-months has opened 517 cases, with 1,6631 clients, and has impacted on CPFS with:

• positive signs of increasing service coordination between the AFSN and CPFS

• a 17.1 per cent decrease from quarter one to quarter three for initial inquiries in 2012-13

• a 44 per cent decrease from quarter one to quarter three in Safety and Wellbeing Assessments (substantiated and non-substantiated) in 2012-13.

The AFSN is also seeing increasingly more cases with higher levels of complexity and carrying a higher level of risk, compared to the experience of agencies pre AFSN operations. Family support is the primary issue for vulnerable clients referred to the AFSN, with approximately 49.5 per cent of cases reporting Family Support as the primary issue of concern

There is emerging evidence of the AFSN leading to improvements in outcomes for vulnerable children and their families:

• there is promising evidence of the AFSN and its partner agencies have positively influenced, and are delivering improvements in circumstances for majority of vulnerable children and their families who have completed their support services from the AFSN. This includes being better able to resolve crisis, improve their capabilities and reduce risk factors to children2.

While difficult to quantify, it is generally acknowledged that the consequences and costs associated with child abuse are severe and wide ranging. Costs include:

• Health System costs

• Education Costs and Productivity losses

• Crime and Justice

• Costs of Protection and Care Programs

• Burden of disease.

In summary, the economic analysis demonstrates that the benefits resulting from participation in the AFSN are likely to significantly outweigh the costs associated with the program. In aggregate, it is estimated that for every dollar invested to support the participation of

1 Note – there were minor discrepancies in the client counts from the client and case table 2 It is however important to note that outcome changes will only be evident over the medium to long term, not the short term. It will require a minimum of three years to allow for direct attribution of any improvements to outcomes to the AFSN.



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children and families in AFSN, the Western Australian Government and the community will save at least $2.06 in reduced expenditure on future CPFS activities, out-of-home care, and avoided lifetime cost of child abuse and neglect. This equates to a net benefit of around $1,052 per AFSN client participating in the program.



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1 Introduction The Department for Child Protection and Family Support (CPFS) has been implementing a large-scale reform agenda aimed at integrating family support services across Western Australia (WA). The establishment of Secondary Family Support Networks (FSN) is critical to achieving this integration. The aim of the networks is to provide a consistent and stronger approach to family support services, including parenting support, counselling (family/financial/alcohol and substance abuse) and programs to reduce conflict within families. These services will provide earlier responses for vulnerable children and their families and reduce the need for child protection statutory responses where possible.

The Armadale Family Support Network (the AFSN) is the first FSN to be implemented in WA. It is located in the Armadale district and is led by Parkerville Children and Youth Care Inc (Parkerville). The AFSN began taking clients from 2 April 2012, with a formal launch on 22 May 2012. Since its establishment, the AFSN has brought on 13 partner agencies providing a range of services spanning family support, counselling, housing and tenancy support, domestic violence services and outreach. Working relationships have also been developed with schools, local governments, the Armadale Hospital and Aboriginal agencies.

1.1 Evaluation purpose and scope The objectives of the evaluation are to:

• assess the evolving implementation of the AFSN and identify emerging good practice, enablers, barriers and opportunities to strengthen the AFSN

• examine the possible emerging impacts that the AFSN has on reported abuse and neglect in the Armadale District

• provide some early indications of the effectiveness of the AFSN in achieving positive client and child protection outcomes

• assess the effectiveness of the role of the community-based child protection leader in the AFSN as well as the AFSN’s relationship with the Armadale CPFS District Office

• identify other opportunities, challenges and possible strategic directions.

1.2 Evaluation methodology The evaluation period was from April 2012 to March 2013 and the methodology consisted of four stages, as outlined in the figure below.



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Figure 1: Evaluation stages

Source: KPMG

1.3 Evaluation design The evaluation has been tailored to consider the context of the innovation site and its progress to date. The evaluation approach and method considered:

• the unique evaluation needs of a single network innovation site in metropolitan WA at Armadale

• the population of the Armadale District, including the high population of children and families from an Aboriginal background

• the implications of other reform programs happening in the area

• the need to present information (particularly quantitative information) relating to the success of the AFSN innovation site, in a short period of time

• experiences in other jurisdictions.

1.3.1 Evaluation questions

Based on the evaluation purpose and context, the questions in Table 1 (below) were developed to frame the evaluation.

Stage

Stage 1

Stage 2

Stage 3

Stage 4

Activities

Project initiation

Refinement of the evaluation plan /

framework

Evaluation implementation

Final reporting

Deliverables

Project plan

Final evaluation framework

Six-month draft and final evaluation report and

presentation

Draft and final evaluation report and presentation



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Table 1: Evaluation questions

Area of focus Evaluation question

Implementation 1. Has the AFSN been implemented as outlined in the Secondary Family Support State Plan 2010-2013 and Operating Framework?

2. How effective was the implementation?

Impact on service delivery

3. How has integration influenced the delivery of services within the AFSN?

4. Have there been improvements in case management and information sharing processes within AFSN agencies?

5. Have any significant gaps in service been identified in the operation of the AFSN?

6. What have been the impacts on CPFS in moving these families to an earlier part of the service system?

Outcomes for clients

7. How has the innovations site influenced outcomes for vulnerable children and families?

8. Are children, young people and families better able to resolve crisis and promote the safety of themselves and their families?

9. Has the AFSN supported individuals and families to promote the developmental needs, safety and wellbeing of at risk children?

Resource consequences

10. What have been the resource implications of implementing the innovations site?

11. Have there been any resource savings to CPFS, AFSN partner agencies or in other areas, as a result of implementing the AFSN?

12. Have there been resource increases (either to CPFS or partner agencies) in any related areas as a result of implementing the AFSN?

Source: KPMG

1.3.2 Data sources

The key data sources for the overall evaluation were:

• analysis of administrative data from CPFS and the AFSN, including case and client issues and outcomes.

• outcomes analysis, focussing on changes in child and family risk characteristics and parenting capacity/family functioning. Data was collected through routine assessment of



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children and families, and data collected at entry to the AFSN was compared to exit data to assess the contribution of services to change for vulnerable children and families.

• cost efficiency and effectiveness analysis to assess whether the benefits of the AFSN outweigh the costs of reform by calculating the components of incremental costs and consequences.

• consultation with key stakeholders to gain qualitative information around the implementation, service delivery, costs and effectiveness of the AFSN. Consultation was undertaken with CPFS, Parkerville, partner agencies, practitioners and a number of other relevant stakeholders (such as schools, local government and the Armadale Hospital). A list of stakeholders consulted in contained in Appendix A.

1.4 Structure of the report The structure of this report is:

1. Introduction Outlines the purpose and methodology of the evaluation.

2. Context of the Armadale Family Support Network

Outlines the policy context that led to the development of the AFSN and the proposed Operating Framework, detailing how it will work in practice.

3. The Armadale Family Support Network

Provides an overview of the Armadale district and the elements of the AFSN. IT also discusses the AFSN’s alignment with the Operating Framework and the effectiveness of its implementation.

4. Outcomes for clients Summarises the key findings from the first twelve months for clients of the AFSN.

5. Impact on CPFS This section outlines the impact the AFSN has had on CPFS.

6. Resource consequences

Provides an overview of the financial outcomes (including benefits) of the AFSN.

Appendix A List of stakeholders

Appendix B Detailed Cost Benefit Analysis assumptions



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2 The policy and operating model underpinning the Family Support Network This section outlines the operating model for the FSN. It outlines the:

• policy context in Western Australia

• the operating framework of the FSN

• benefits of FSNs.

2.1 Policy context A number of policy directions detailed within current literature on working effectively with vulnerable children, youth, families and communities have also informed the development of the FSNs. For example, the development of service models which aim to deliver integrated and coordinated interventions to vulnerable children and families are seen to be increasingly effective as:

• there is a need for earlier and responsive intervention and prevention – research has shown that high-quality programs that are delivered earlier indicate long-term and positive outcomes for children3.

• there is need for a holistic view of the child with a focus on development and best interests – particularly looking at safety and stability of children and their development milestones4.

• brain development in the early stages of life is particularly key in the development and outcomes of children and young people into adulthood – early childhood development can be seriously impaired by social, economic and regulatory environments.5

• services should support both families and children - evidence suggests that if parents experience difficulties and issues, the impact for children can be negative across the lifespan. The context of the family should therefore be considered when delivering services to children. Furthermore, family members are key resources for children’s ongoing needs and development.6

• there is a need for services to be coordinated and have a shared approach – encompassing services across the service continuum such as specialist and universal services, to ensure that key professionals are consulted at key points, to provide one entry point for families, to engage families more systematically and to target client problems more effectively.7

3 Sykora. J (2005). Off to a Better Start: What we Know About Early Intervention Services. 4 http://www.cyf.vic.gov.au/__data/assets/pdf_file/0011/43013/ecec_best_interest_framework_proof.pdf - accessed October 2010 5 Shonkoff, J.P and Phillips, D, From Neurons to Neighbourhoods: the science of early childhood development, pg.5. 2010, National Academy Press. 6 Ibid. 7 Social Exclusion Task Force (2007). Reaching Out: Think Family; UK.



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• services should address the cultural needs of Aboriginal and Torres Strait Islander children and families – with research stating that Aboriginal and Torres Strait Islander children are almost five times more likely to be placed in out-of-home care compared with non-Indigenous children8. Aboriginal children and their families also have specific needs including ensuring that children are culturally safe9, while mainstream agencies also have a role in ensuring their services are culturally competent and appropriate in providing suitable and safe responses.

2.1.1 Western Australian context

The Secondary Family Support State Plan 2010-2013 (State Plan) provides the framework for a statewide integrated secondary services model for vulnerable and at-risk children, young people, their families and communities.

The vision of the State Plan is to develop a statewide network of high quality, integrated services that support children, individuals and families to appropriately address the risks and crises that they experience.

The State Plan outlines the high-level framework and strategies for the development of the FSN including aims and objectives, guiding principles, key stakeholders to be included, secondary services within scope, governance frameworks and the support structures required. This document guided the development of the Operating Framework for the FSN.

CPFS, partner Government agencies and the community sector worked in partnership to develop the State Plan and the framework to assist with the implementation of the FSN. The Community Sector Roundtable guided the development of the State Plan, comprising senior CPFS and community sector representatives. Other support to drive the reforms included:

• The Family Support Network Steering Group (consisting of Government and Non-Government members)

• The Family Support Network Working Group

• Three task groups to develop the following resource documents, available at www.whereto.org.au:

− a common assessment framework

− information sharing protocols

− an MOU to set out role clarity between partner organisations

− a communications strategy.

The work to develop the concept and elements to support the FSN took approximately two years before the tender process was undertaken.

The FSN operates within a policy and practice arena which includes a range of other initiatives aimed at addressing vulnerability within the Western Australian (WA) community more

8 Australian Institute of Health and Welfare (2007). 9 Australian Institute of Family Studies (no date). Indigenous Responses to Child Protection Issues.



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broadly, including the Child and Parent Centres recently announced by the Government that work with a child’s early development and school readiness needs – not the complexity of issues that the FSN would assist children and families with.

2.1.2 The operating framework

The operating framework provides the detail for how networks will operate on the ground.

Figure 2 illustrates some of the key elements of the network, including:10

• a common entry point (CEP) into the local service network, with partner agencies to adopt a ‘no wrong door’ philosophy to connect clients with services

• client screening where initial client information is collected by either the CEP or the partner agency

• common approach to assessment so that the risk and need of each client can be effectively identified and addressed

• allocation of cases based on greatest risk and need, and capacity of partner agencies to provide a response

• ‘active holding’ rather than a traditional waitlist response

• coordinated demand management where the lead agency has oversight of district level demand for both child protection and family support services.

• differential service intensity based on the assessment and case planning process.

10 DCP, 2010, Operating Framework for Secondary Family Support Hubs



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Figure 2: Client pathways through a proposed network

Source: Operating Framework for Secondary Family Support Hubs, 2010

2.2 Benefits of an integrated and coordinated approach In developing the operating model, a results logic framework (see below) outlines the intended outcomes and benefits.



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Figure 3: Results logic framework

Source: KPMG

The benefits of an integrated and coordinated approach include:

• better integration and coordination of service to families and children - family support services should be more visible and accessible in the local community. This includes:

- improving the experience of those people seeking assistance through streamlined service delivery

- allowing for a personalised, comprehensive and coordinated approach to addressing complex and interrelated challenges

INPUTS / STRATEGIES

1. Systems Governance

• Governance structures• Integration processes• Data analysis and

planning• Quality mechanisms• Engagement of universal,

secondary, specialist services and Child Protection

• Engagement of Aboriginalagencies as partners in hubs

2. Service delivery structures

• Implementation of the hubs and their functions (e.g. intake, eligibility determination,assessment, prioritisation and allocation, and demand management)

• Identification of Aboriginal children and families

• Establishment of clear referral Pathways

• Coordination with Child Protection

• Coordination with universal, secondary and specialist services

3. Practice development• Processes and structures

to build sector knowledge, skills and competencies to work with more vulnerable children and families (e.g. rigorous assessment,early childhood development, cumulative harm, trauma based practice, relationship based practice, criticalreflection and cultural competence)

3. Sector capacity building

• Expansion of existing services

• Introduction of new services

• Strengthening the Aboriginal agency sector

• Strengthening the capacity of mainstream services to deliver services to Aboriginal children and families

• Building capacity to collaborate

CLIENT OUTCOMES• Improved safety , stability and development of children and young people• Stronger capacity for vulnerable families to care for children and young people in the community without the

requirement for Child Protection intervention

SYSTEM IMPACTS• Better integration and coordination of services to children and families• Improved access to Secondary Family Support Services by vulnerable and at -risk children and families • Increased Service System capacity to intervene with vulnerable children and families• Effective diversion of vulnerable children and families from Child Protection (or minimised progression )• Increase in Aboriginal representation in Family Support Services• Reduction in Aboriginal overrepresentation in Child Protection

,

,

.

POPULATION OUTCOME

• Improved safety and wellbeing of children and young people in the Western Australian population



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- unifying service approaches towards shared outcomes

- strengthening the links between services by incorporating agreed processes

- assisting people with complex needs to be supported through integrated case management over a longer period of time

• diversion from Child Protection services, or a minimisation in the increase of inquiries to the Child Protection

• better coordinated services between Child Protection and Secondary Family Support services, that better target vulnerable families

• increased understanding and service coordination between Family Support Services and universal, secondary and specialist services

• potential financial return as the benefits can outweigh costs.

2.3 Avoided costs The report, Transition from care: Avoidable costs to government of alternative pathways of young people exiting the formal child protection care system in Australia, provides an indication of the costs that could be avoided by improving outcomes for vulnerable children and families.

The report found that it can cost government approximately $46 million per annum to provide services to people aged 16 to 18 years who have left the formal child protection care system. This can be contrasted to the $3.3 million per annum it would cost to service the same number of people in the general community. This means that the net cost to government is approximately $43 million per annum or $1.9 billion over a 44-year life cycle.11 Other costs include cost per placement night and cost per child protection case.

People who have left the formal child protection care system are likely to earn less than the general community. This means that there are tax dollars foregone as a result of the lower likelihood of employment. This is estimated to be $2 million per annum for the 16-24 years age group, and $5.4 million per annum for the 25-60 years age group.12

The FSN investment will allow for a strengthening and a focus on those who are vulnerable, with potential benefits including:

• mitigating against increased risk to vulnerable children. By engaging vulnerable and at-risk children and families earlier, the potential for an escalation in risk is reduced. Addressing the needs of children and families earlier will lead to a potential reduced demand on the Child Protection system, reduced burden on the Child Protection workforce and better outcomes for children and families.

• reduced risk to government of future claims from children who received poor care.

11 Morgan Disney and Associates Pty Ltd and Applied Economics Pty Ltd (with Evolving Ways), 2006, “Transition from Care: Avoidable Costs to Governments of Alternative Pathways of Young People Exiting the Formal Child Protection Care System in Australia – Volume 1 Summary Report”, 12 ibid



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• reduction of higher rates in adult life of (over the long term):

- health problems and hospital admissions

- psychological and psychiatric problems

- drug and alcohol addiction

- incarceration rates

- family breakdown

- unemployment.

FSN services should:

• actively engage children and families at the point that vulnerability is identified

• coordinate service delivery to vulnerable children and families at a local community level

• provide publicly known access through a common entry point.

2.4 Summary The FSN is a new approach to service delivery for secondary family support services and is a key element of reform to the way in which services are provided to vulnerable children and their families.



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3 The Armadale Family Support Network This section provides an overview of the AFSN. It includes:

• description of the Armadale district, including key socio-demographic characteristics

• overview of the AFSN

− description of the AFSN’s structure and key stakeholders (common entry point and partner agencies)

− description of the AFSN operational model.

3.1 The Armadale district The CPFS classification of the Armadale district includes the following Statistical Local Areas:

• City of Armadale: postcodes 6111 and 6112

• City of Gosnells: postcodes 6108 to 6110

• Shire of Serpentine-Jarrahdale: postcodes 6113 and 6121 to 6126.

The district also includes Kenwick (postcode 6107).

Key characteristics of the Armadale district based on the 2011 census13 are as follows:

• 2.5 per cent of the population are Indigenous. While this is lower than the State average of 3.1 per cent, it is important to ensure that services are culturally appropriate as research shows that Indigenous children are almost five times more likely to be placed in out-of-home care compared with non-Indigenous children.

• 59.9 per cent of the population is born in Australia, which is lower than the State average of 62.9 per cent.

• 5.0 per cent of the population is estimated to be unemployed, compared to the State average of 3.8 per cent. This increases the risk and vulnerability factors for children, young people and their families.

• 21.9 per cent are single parent families with children under 15 years of age compared to the State average of 19.9 per cent.

• 14.9 per cent of jobless families have children less than 15 years of age compared to the State average of 12.3 per cent.14

• 10.6 per cent of all families are welfare-dependent or on low incomes, compared to the State average of 8.8 per cent.15

13 Public Health Information Development Unit. Social Health Atlas of Australia: Medicare Locals, published 2012, <http://www.publichealth.gov.au/data/social-health-atlas-of-australia%3a-medicare-locals_-published-2012.html> accessed September 2012 14 Based on 2006 census data as the 2011 census data was not available. 15 Based on 2006 census data as the 2011 census data was not available.



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The Armadale district experiences greater levels of vulnerability than the State average, and as such, the risk factors to children’s normal developmental progress may be increased.

3.2 Overview of the Armadale Family Support Network This section presents an overview of the AFSN model.

3.2.1 Timeline to the AFSN

Parkerville was selected as the lead agency in December 2011 charged with the responsibility for establishing the first FSN in WA. Upon being awarded the tender, Parkerville immediately commenced the development of the AFSN. The figure below provides an overview of the major milestones associated with the establishment of the AFSN.

Figure 4: AFSN timeline

Source: KPMG

The AFSN operates with partner agencies who are providers of secondary family support services. Partner agencies have signed memoranda of understanding (MOU) which bind them to an agreed approach to service provision. Currently, the following organisations are AFSN partner agencies:

• Armadale Youth Resources

• Centrecare

• Communicare

• Coolabaroo

• Department for Child Protection and Family Support, Armadale District

• Drug ARM WA

• Minnawarra House

• Mission Australia

• Relationships Australia

Jul 2011 Dec 2011 Jan 2012 Apr May

July 2011Tender released by DCP

December 2011Parkerville awarded AFSN pilot project

January 2012Parkerville begin identifying partners

April 1 2012Soft launch of AFSN, inc. CEPoperational

May 22 2012Official launch of AFSN

June July

June/July/Aug 2012Partners still being identified and education of community/services is being undertaken



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• Ruah Community Services

• Starick Services

• Wanslea Family Services.

The current list of partners is not exhaustive. New partners can be added as required either where there is interest in participating in the AFSN or where a specific need is identified. This level of flexibility ensures an appropriate mix of services is available based on community need (this approach recognises that community need may change over time therefore, additional partners can be included in the AFSN as required).

Figure 5 outlines the AFSN operational model to address client needs on a day-to-day basis.

Figure 5: Overview of the AFSN operating model

Source: adapted by Parkerville from the Operating Framework and Practice Processes

Families

Referral Walk in Email 1300 Phone

Common Entry Point

Partner Agency

Initial Screening

Brief Intervention Stage 1 Assessment Inappropriate Referral

Information provided to link to other services

Closure

Closure Stage 2

Assessment if required

Case Plan Developed with Family

Allocation to Services via Allocations Meeting Allocation to Services via Common Entry Point Team

Active Holding

Service / Services provided

Case Closure 12 month Follow Up support if

requested



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The table below compares the core elements of the AFSN Operating Model with those of the original FSN model.

Table 2: Overview of comparison between FSN and AFSN

Key element Family Support Networks

Armadale Family Support Network

Common Entry Point Adopting a ‘no wrong door’ policy

Yes – a key element of the AFSN

Client Screening Initial information collected by CEP or Partner agency

Yes – CEP and Partner’s collect initial information

Common approach to Assessment To identify risk and need consistently

Yes – use of Common Assessment tool (not universal across all partner agencies)

Allocation of Cases Based on need, risk and capacity

Yes – however, capacity issues at Partner agencies has impacted on AFSN ability to allocate to Partner’s

Active Holding To move away from traditional waitlist response

Yes – active hold undertaken by CEP

Coordinated Demand Management Oversight of district level demand

No – Partner agencies have not provided capacity status to AFSN

Differential Service Intensity Based on assessment and case planning

Yes – different service intensities

Source: KPMG

3.3 AFSN client characteristics For the period April 2012 to 31 March 2013 the AFSN had 1,66316 clients. The table below provides an overview of the age range and gender of clients.

16 Note – there were minor discrepancies in the client counts from the client and case table



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Table 3: Client counts by age and sex

Gender 0 - 9 yrs 10 – 19 yrs 20 - 29 yrs 30 - 39 yrs 40 - 49 yrs 50 - 59 yrs 60+ yrs Total

Female 233 219 101 214 98 13 14 892

Male 263 248 45 94 55 11 5 721

Missing/other 16 12 8 7 7 50

Total 512 479 154 315 160 24 19 1,663

Source: THE PROJECT TEAM

Approximately 60 per cent of clients were aged 0 to 19 years old. This is consistent with expectations that the AFSN is working with vulnerable children.

Table 5 below presents further characteristics of the clients of the AFSN.

Table 4: Client counts by Indigenous status and country of birth

Characteristics

Indigenous Status Aboriginal and/or Torres Strait Islander – 177 clients

Unknown/not recorded – 1,486 clients

Country of Birth Australia – 1046 clients

Top three other countries:

• Great Britain – 36 clients

• New Zealand – 32 clients

• Tanzania – 7 clients

Unknown/not recorded – 493 clients

Source: FuSioN, modified by KPMG

While the available client information provides an understanding as to the age and gender of the attending clients, the limited recording of Indigenous status and country of birth makes it difficult to assess the cultural diversity of the clients; which in turn makes it difficult to determine whether the services offered by the AFSN are ‘culturally accessible’.

There have been 177 clients that identify as Aboriginal or Torres Strait Islander - potentially equating to about one in ten clients. While improvements have been made in the data recording for indigenous status with a focus recording for all clients, this is still not occurring, and as recommended in the six-month report, consideration should be given to making the recording of demographic information mandatory and adjusting the available categories to enable a better picture of client characteristics to be formed.

60 per cent of clients: aged 0 – 19 years…



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Finding:

The AFSN is working with vulnerable children as per the objectives of the AFSN model. The majority are Australian, and there is still a recording issue on the Indigenous status of clients.

3.4 Activity levels of the AFSN – the first 12 months The number of cases and clients per month (approximately 45 cases and 150 clients per month) remained steady throughout the period May 2012 to March 2013 – see figure below.17

Figure 6: Number of cases and clients by month

Source: FuSioN modified by KPMG

The activity levels remaining at a consistent level has also provided a good test of resourcing the CEP and ensuring there is an effective and timely response. Brokerage funds have been used to increase capacity in the CEP through an additional ASO. Prior to this, the two ASOs had approximately 70 active cases each, and the Alliance Manager was also taking on some cases. The addition of the extra ASO has resulted in a current active caseload of approximately 50 cases. This is a heavy workload and is not sustainable over the medium term.

3.5 Referral source and type From April 2012 to March 31 2013 there were 517 cases that come through the AFSN. There are now 41 clients that have more than one case, that is, they have returned to the AFSN, with two clients (of the 41) having returned three times. This is a positive trend as it suggests individuals/families are willing to reach for assistance rather than let their situation escalate potentially moving to a higher risk threshold. 17 Please note: Data is limited as partner agencies are still accepting direct referrals which, when the network is fully operational, should be counted in the referral numbers.

0102030405060

0

50

100

150

200

250

Cases

Clie

nts

Clients Average clients per month

Cases Average cases per month

Christmasperiod



21




The table below outlines the referral types and the number of cases and clients by each source at the six and twelve month points.

Table 5: All cases by referral type

Referral type Six month cases

Six month clients

12 month cases

12 month clients

% Change in cases

% Change in clients

Agency 120 344 296 935 147 % 172 %

Individual 70 228 214 731 206 % 221 %

Other 3 5 7 17 133 % 240 %

Total 193 577 517 1,683 168 % 192 %


The main referral sources to the AFSN have been from local schools, health services and self referrals. The referral trend from local schools reflect the nature of the issues that some students and their families face and they highlight that schools require additional support to assist those students and families. Of note has been the increase in referrals from the six-month point to the 12-month point – in all cases at least doubling previous number of referrals, cases and clients. This highlights the increasing visibility that the AFSN has in the Armadale District, and the alternative pathway that referrer’s now have available to them to support potentially vulnerable children, youth and families.

Finding:

Referral patterns highlight the increasing visibility and accessibility of the AFSN in the Armadale region which is providing an alternative pathway for vulnerable children and families.

Table 6 presents the referrer role information. Of note is the number of Missing/Other, which has substantially increased since the six-month point.



22




Table 6: Cases by referral type and referrer role

Referral Type Referrer role Six month

cases Six month

clients 12 month

cases 12 month

clients % Change in

cases % Change in

clients

Agency

Missing/other 29 75 135 422 1025 % 1658 %

Social Welfare Professional 61 206 85 278

39% 35 %

School Personnel 17 48 38 117

19 % 29 %

Health professional 33 107 37 118 185 % 269%

Police Personnel

11 39 - - - -

Individual

Family member

63 221 149 547 237 % 248 %

Missing/other 28 93 52 161 186 % 173 %

Member of Public 3 6 9 15 300 % 250 %

Carer/friend 4 8 n/a n/a

Other

Missing/other 3 6 4 11 133 % 133 %

Family member 0 0 1 3 n/a n/a

Member of Public 0 0 1 1 n/a n/a

Social Welfare Professional 0 0 1 2 n/a n/a

Total 246 792 517 1,683 110 % 210 %


There has been an increase in individual referrals from family members as the community becomes more comfortable with the AFSN and it increases its visibility. While referrals have increased to the AFSN, the referrals from police have decreased slightly over the last six-month period.



23




Learning:

For future consideration it may be easier to collapse the 17 categories currently available for Referrer role into a smaller subset (such as, have three or four categories for Individual referrals - member of the public, family member, self) and four or five categories for agency referrals (such as, school personnel, police personnel, healthcare personnel, social welfare personnel, other personnel). This will assist with data capture into the future and reduce the missing data.

3.6 Summary The operating model established by Parkerville, and currently being implemented, is based on the vision of the State Plan and the Operating Framework developed by CPFS and the community sector, with ten partner agencies signing on to be involved in the AFSN.

Activity levels have been consistent across the 12-month period, and since the six-month report, referrals, cases and clients have more than doubled, indicating that the AFSN is providing an increasingly accessible pathway into the secondary service system for vulnerable children, youth and families.



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4 Implementation of the AFSN Implementation planning is critical to the success of any new initiative, and appropriate planning, resourcing and time are all factors that can impact on implementation.

4.1 Implementation overview The Australian Policy Handbook18 provides a suitable reference for effective implementation and it outlines the ten conditions for perfect implementation, including: 19

• no crippling external constraints

• adequate time and resources

• a suitable combination of resources at each stage

• a valid theory of cause and effect

• direct links between cause and effect

• a single implementation agency, or at least a dominant one

• understanding and agreement on the objectives to be achieved

• a detailed specification of tasks to be completed

• perfect communication and coordination

• perfect obedience.

The table below provides an outline of the implementation planning for the AFSN compared to the ten conditions outlined for effective implementation.

Table 7: Overview of AFSN implementation vs. conditions of implementation

Implementation conditions AFSN assessment

No crippling external constraints None identified.

Adequate time and resources As per the timeline, the AFSN had limited time to develop partnerships with agencies which has impacted certain key elements of the operating model, including managing capacity, case allocations and referrals from agencies.

A suitable combination of resources at each stage $458, 700 is provided by the Department each year, for 3 years to fund the Lead Agency/Common Entry Point team;

- One FTE Leader Child Protection is provided by the Department, based in the CEP; and

18 Althaus, Catherine; Bridgman, Peter and Davis, Glyn, ‘The Australian Policy Handbook’, pg. 160. 2007, Fourth Edition. 19 As first outlined in Gunn, L.A. “Why is implementation so difficult”, Management services in Government, 33:169-76.



25




Implementation conditions AFSN assessment

- $1 million per year, for 3 years is provided by the Department to increase service capacity in Armadale.

A valid theory of cause and effect Yes – the concept of the FSN/AFSN has been based on documented evidence that ealy intervention can be successful.

Direct links between cause and effect As above

A single implementation agency, or at least a dominant one

Mixed – while Parkerville, as the Lead Agency, implemented, CPFS was involved to help facilitate implementation, however, it was noted that CPFS took a hands off approach in the early stages and have since become more involved.

Understanding and agreement on the objectives to be achieved

Mixed – based on the development of the FSN concept there were agencies who were not involved and had limited understanding of the concept. This has impacted on the AFSN as partner agency understanding is variable therefore the ability to operationalise the FSN concept is compromised.

A detailed specification of tasks to be completed Mixed – documents were developed that outlined tasks, however, these were not detailed and did not include change strategy, communications strategy, and resourcing requirements.

Perfect communication and coordination Mixed - based on the development of the FSN concept there were agencies who were not involved in the development process and had limited understanding of the concept. Further education and information activities needed to occur to support the roll out of the AFSN.

Perfect obedience No – due to timeline pressures partner agencies were required to be signed quickly and without full understanding of the FSN concept (as they were not involved in the development process), MOUs have also been signed after the AFSN became operational. This has impacted on the level of involvement in the AFSN, particularly with the key elements of managing capacity and referring to the AFSN.

Source: KPMG



26




The operating model set out by Parkerville, and currently being implemented, is based on the vision of the State Plan and the Operating Framework developed by CPFS and the community sector, with 12 partner agencies signing on to be involved in the AFSN. This represents a significant achievement, in terms of engaging and signing partner agencies, given the short timeframes the AFSN had from confirmation of the AFSN to beginning operations within four months.

Overall, the AFSN has made good progress in a number of area’s, including:

• alignment to original intent and operating model

• providing an accessible and visible point of contact in the local Armadale District, with a proportion of self referrals and good links with local schools and health services

• the good beginnings of coordinated services and building trust across the partner agencies

• identification of service gaps in the provision of support to vulnerable children and their families.

However, the lack of comprehensive implementation planning for the AFSN as a result of the short timelines has impacted on the overall effectiveness of the AFSN. The compressed timelines from notification of lead agency to operations, notwithstanding the two years of work in the lead up to the AFSN, impacted on:

• engagement of partners into the AFSN

• partner understanding of the AFSN concept, as some partners were not involved in the two years of work in developing the FSN concept

• operations of the AFSN, as the operations began while implementation activities were still underway

• finalisation and agreement of protocols and processes including capacity management, information sharing, working relationships with CPFS and referrals to the AFSN by partner agencies.

The AFSN has provided important learnings for the future FSNs in WA, in particular, resourcing implications for both implementation planning and the CEP – highlighting the need for further resources to implement the AFSN, and to meet demand when operations begin - further information and education of local agencies not involved in the two years of pre-work to develop the FSN and development of protocols/processes that need to be in place before the operations begin, such as case management responsibilities and referral practices to the CEP.

Finding:

For future FSNs consideration should be given to:

• Ensuring all agencies in the local area understand the concept of the FSN, the objectives and what it means to participate in a FSN.

• CPFS testing partnerships prior to any future FSNs. The success of future FSNs may depend on whether such collaborative arrangements are already in place and whether or not their



27




effectiveness is already observable.

• Developing detailed implementation planning for future FSNs, at both the local level and at CPFS level.

4.2 Future considerations for future FSN implementation To ensure the delivery of desired program outcomes, for any new initiative it is critical that an implementation plan is developed to guide the establishment of a new way of working as is proposed under the FSN operating model framework. Implementation planning helps manage the ambiguity and uncertainty that occurs during the establishment of new structures, mechanisms, and processes as outlined in the FSN operating model. To ensure that the planning processes are effective consideration needs to be given to the following core elements:

• Change management: to ensure a controlled transition and is aimed at reducing risks.

• Communications strategy: to provide information about the reforms (i.e. the reasons for the change, the benefits of change, assistance provided during the change process etc) and; secondly, to build momentum and anticipation about the change, what the new ‘system’ will look like, and the benefits of this to an individual, organisation and the community.

• Governance methods: to assist with managing the transition and then the service.

• Infrastructure requirements: list the infrastructure requirements during implementation and prepare any budgets to meet costs.

• Risk management: important to implementation, as it helps to package and rate the key risks areas before implementation.

• Stakeholder engagement: the process of identifying the interested or influencing stakeholders and communicating with them effectively. Proper stakeholder engagement is essential to the program’s success and thus a stakeholder engagement strategy is important in implementation.

• Timeline: identifying key milestones in the implementation process will ensure that program outcomes are met in line with the stakeholders’ expectations and that infrastructure is available as required.

For future FSNs, CPFS (Head Office) will need to be involved throughout the implementation process to provide support, guidance, information and decision making authority. While recognising the support and involvement of CPFS from the District level, those resources are already stretched responding to local statutory response issues and CPFS Head Office assistance would be required to implement and collaborate with FSNs.



28




5 Outcomes for clients This section outlines the outcomes for clients of the AFSN. It includes information on:

• entry and exit scores of client self assessment on the outcome measure “improvement in parental capabilities, support, and protectiveness”

• entry and exit scores of client self assessment on the outcome measure “reduction in risk factors experienced by children and young people”

• feedback from stakeholders and case studies highlighting the work of the AFSN and the outcomes for the children and their families.

5.1 Completed cases Of the 517 cases at 31 March 2013, 299 were completed cases. The table below presents an overview of those cases that have been completed, and days from referral date to case closure.

Table 8: Closed cases by closure reason

Closure reason Six month Cases

Six month Clients

Six month Average total

effort per case (hours)

Six month Average time

from referral to closure (days)

12 month Cases

12 month Clients

12 month Average time

from referral to closure (days)

Case Completed 26 64 2.4 16.5 149 466 36

Client Disengaged 29 74 2.3 40.0 100 295 43

Inappropriate Referral 18 19 1.1 1.4 50 112 9

Total 73 157 2.0 22.1 299 873 34

Source: FuSioN modified by KPMG- note the number of hours is an estimate of the assessment process only.

There has been a six-fold increase of clients who have completed their interaction with the AFSN, since the six-month point. As the AFSN has now been operational for 12 months), more families have completed the support services put in place for them.

The number of inappropriate referrals has decreased as a proportion of total cases in recent times. At the six-month point 24.6 per cent of referrals were inappropriate, compared to 16.7 per cent at the 12-month point. Figure 7 below outlines the monthly activity for case closure, disengagement and inappropriate referrals.

““At home, things have got so much better now... I didn’t know what else I was going to

do.” – AFSN client



29




Figure 7: Closed cases by reason (case completed, client disengaged or inappropriate referral)


Finding: The number of completed cases has increased since the beginning of operations of the AFSN. The number of inappropriate referrals, as a proportion of total referrals, has decreased over the 12-month timeframe.

5.2 Primary issue of concern The primary issue of concern for most clients across the 517 cases was family support, slightly under half of the cases seen by the AFSN. Table 8 below details the primary issue of concern for cases referred to the AFSN.

0

5

10

15

20

25

Case Completed Client Disengaged Inappropriate Referral



30




Table 9: AFSN cases by primary issue of concern

Primary Issue 6 month cases 6 month proportion 12 month cases 12 month

proportion

Family Support20 62 32.1 % 256 49.5 %

Other Issue 30 15.5 % 87 16.8 %

Housing 22 11.4 % 46 8.9 %

Parent/Teen Conflict 19 9.8 % 37 7.2 %

Parenting Issue 18 9.3 % 31 6.0 %

Mental Health 21 10.9 % 26 5.0 %

Domestic Violence 9 4.6 % 13 2.5 %

Financial Assistance/Substance Use/Missing

6 3.1 % 12 2.3 %

Child Protection 6 3.1 % 9 1.7 %

Total 193 100 % 517 100 %


Family support is the most common presenting issue for the AFSN with approximately 49.5 per cent of cases requiring family support. Of note is the decrease in the proportion of mental health, decreasing to 5.0 per cent of cases since the six-month point.

Focussing on the closed cases and the time spent in screening and assessment provides an indication as to the complexity of the cases as outlined in Table 10.

20 Family Supports include issues such as: developmental delay, relationship difficulties, grief and loss, social isolation, community conflict, legal problems, post trauma support, school problems



31




Table 10: Closed cases by primary issue and average hours spent on screening and assessment

Primary issue Cases Clients

Average effort on screening and

assessment (hours)

Average time from referral to closure (days)

Family Support 87 285 2.2 59.9

Other Issue 54 161 2.4 57.2

Housing 42 102 2.8 31.1

Parenting Issue 18 55 1.4 35.3

Parent/Teen Conflict 28 78 3.2 63.6

Mental Health 18 46 2.0 59.2

Domestic Violence 8 24 1.8 40.9

Financial Assistance 8 17 1.1 18.9

Child Protection 5 9 1.0 4.6

Substance Use 2 6 1.3 47.0


Closed cases where the primary issue was Parent/Teen Conflict had the highest average hours spent on screening and assessment, this has increased from 1.8 hours to 3.2 hours from the six-month report to 12-month report. Parent/Teen Conflict also take the longest time to close, on average 63.6 days, followed by Family Support at 59.9 days (compared to 47 days at the six-month point). Given that Family Support is the predominant primary issue of concern for the AFSN, with an increasing time to assess and complete, the complexity of cases is also increasing. Stakeholders, including practitioners, noted that the AFSN is taking on more complex clients, increasing the threshold of risk they are willing to absorb in terms of client complexity.

Child protection issues tend to require the least effort as these issues can be referred to child protection due to the risk factors involved and the fact that the AFSN may not best placed to respond to this issue – assessment and screening took on average 1.0 hour at both the six-month and 12-month period. Not surprising, Child Protection cases are closed within the shortest time from referral, 4.6 days on average.

“The help that she (the mother) had received was just so beneficial. She wasn’t alone

anymore.” – partner agency



32




Finding:

Family support is the primary issue for vulnerable clients referred to the AFSN, with cases closed, on average 59.9 days after referral. Parenting/ Teen Conflict takes the longest time to assess and the longest time to close. Cases are becoming more complex, with all issues taking longer to complete, even with increased capacity at partner agencies.

5.3 Improvements in family capacity to care / family functioning The AFSN has two self-reported outcome measures. These are:

• improvement in parental capabilities, support and protectiveness

• reduction in risk factors experienced by children and young people.

To measure outcomes the AFSN has a client outcome measurement tool built into the FuSioN IT system.

At the end of the 12 month reporting period there were 79 completed cases that had outcome measure information recorded at entry and at exit (out of the 149 completed cases).

The entry and exit scores are recorded on a scale of one to five based on the perception of clients’ experience during the period they received a service through the AFSN. Clients are assisted to fill this information in when they enter and exit the AFSN.

For the 79 completed cases (or 15 per cent of total AFSN cases) where outcomes were recorded21 the average entry and exit score for the two self-reported outcome measures are outlined in Table 11.

Table 11: Entry and exit scores for completed cases

Measure Cases Clients Average Entry score

Average Exit score

Proportion of total cases/clients

Improvement in parental capabilities,

support and protectiveness

79 287 2.6 3.4 15%/17%

Reduction in risk factors experienced by children

and young people 69 230 2.4 3.3 13%/14%


21 Those cases where the outcome entry score was 0 were not included in the analysis

The AFSN is “a service to come and talk to when they need something,” with clients

coming in an out of the service as “they have had a positive experience and they’ll come

back.” – partner agency



33




The exit score for both outcome measures is higher at exit than upon entry indicating an improvement in capabilities of parents and a reduction in risk factors for children and young people. These results are also on the increase compared to the six-month report, where:

• improvement in parental capabilities has increased further as the average entry score was 2.0

• risk factors for children has increased further as the average entry score was 1.8.

Stakeholders, including partner agencies and practitioners noted that though it is too early to talk about outcomes for children and families, improvements have been observed in improved school attendance and in parents feeling better supported.

Stakeholders also expressed positive views about the AFSN being a safe place to attend, “(The AFSN…is a service to come and talk to when they (vulnerable families) need something,” and “they (the clients) have had a positive experience and they’ll come back.”

Anecdotal feedback from the four schools that have developed a relationship with the AFSN and have referred vulnerable children and their families to the AFSN indicated that those children:

• have improved attendance at school and are improving in their ability to work with the curriculum

• have progressed in terms of their social and emotional wellbeing.

These improvements indicate that the AFSN is beginning to have a positive impact on vulnerable children and their families. Most stakeholders indicated that the accessibility of the AFSN provides to services, coupled with the service families are receiving, is a great outcome in, and of itself.

Finding:

For those completed cases where outcomes have been recorded, vulnerable children and families have recorded improvements in the outcome measures:

• improvement in parental capabilities, support and protectiveness

• reduction in risk factors experienced by children and young people.

While it is still early to directly link improved outcomes to the AFSN (having only been in operation for 12 months) there appears to be evidence of promising progress emerging to suggest positive outcomes will be delivered.

As a result of clients undertaking a self-assessment at the beginning of their support period and when completed, FuSioN also generates an achievement scale that captures the difference between entry and exit scores. The achievement scale is:

A single parent family with two children, the father having passed away when the child was a baby, was referred to the AFSN. One child had a medical condition which meant the child’s behaviour was “trying” (anxious behaviour). As a result of the AFSN services, the mother received assistance with her parenting skills that led to improvements in the child’s behaviour (less anxiety). The mother was pleased with the services and the outcome. – practitioner at partner agency



34




• 0 or negative score = Nil achievement

• Difference of 1 = Partial achievement

• Difference of 2 or 3 = Good achievement

• Difference of 4 = Significant achievement.

The table below outlines the achievement scores for those clients who have outcome measures recorded.

Table 12: Count of cases for each outcome by achievement scale

Measure Six month Outcome 1

Six month Outcome 2

12 month Outcome 1

12month Outcome 2

Nil achievement 2 7 29 24

Partial achievement 6 5 30 29

Good achievement 2 1

20 16

Significant achievement 0 0 0 0

Total 10 11 79 69


Approximately 63 per cent of clients with recorded outcome data have recorded a partial, or good achievement for Outcome 1, and 65 per cent of clients have recorded a partial or good achievement for Outcome 2.

While it is early to directly attribute all improvements to the AFSN, there is promising evidence of positive improvements in circumstances for majority of vulnerable children and their families who have completed their support services from the AFSN.

Finding:

The majority of clients have not only recorded improvements in outcomes, but have also recorded positive achievement in completing their support with AFSN.

The WA FSNs are leading practice in the human service sector systems in Australia, through having a data collection method to measure client outcomes.

5.4 Summary There is emerging evidence of the AFSN leading to improvements in outcomes for vulnerable children and their families, including:

63 per cent positive achievement 65 per cent positive achievement



35




• promising evidence of the AFSN and its partner agencies have positively influenced, and are delivering improvements in circumstances for majority of vulnerable children and their families who have completed their support services from the AFSN. This includes being better able to resolve crisis, improve their capabilities and reduce risk factors to children.

• Whilst promising indicators are apparent, absolute outcome changes will only be evident over the medium to long term, rather than the short term. It will require a minimum of three years to allow for direct attribution of improved outcomes to the AFSN.

For future FSNs it is important to ensure that outcome information is developed and captured from the beginning of operations and that processes are in place for case closure reviews to ensure that required outcome data is captured for the majority of clients/cases.



36




6 Impact on CPFS This section outlines the impact of the AFSN on CPFS including:

• the working relationship with CPFS and the AFSN

• changes in activity for the CPFS Armadale, including comparison to other CPFS districts.

6.1 The AFSN and child protection The AFSN and CPFS have started to work together closely, at the both the Central and Armadale level. CPFS Armadale have, over the past 12-months, started to:

• refer clients of CPFS to the AFSN (that is, open cases), where additional support is required for the child and family

• refer members of the community who “walk-in” into CPFS offices to the AFSN, who do not meet the “risk threshold” for CPFS, however, do require assistance to manage the vulnerability and current issues.

While the referrer role data does not disaggregate “social welfare professional” 37 of the 85 referrals from this category were from CPFS Armadale.

During the first year of operation there has been increasing service coordination between the AFSN and the CPFS Armadale District, including improved referral processes from CPFS Armadale to the AFSN so that there are fewer “inappropriate referrals”. Some of the issues that the AFSN and CPFS have been addressing relate to:

• whether a case should remain with CPFS or be referred to the AFSN if secondary services are required

• responsibility for overall case management

• scope for co-work and visitations to families.

Located within the AFSN is the Leader Child Protection, who is a Team Leader equivalent. The position has been turned over, which has resulted in differing tasks being carried out depending on the person in the position. There has been a lack of clarity around the role of the Leader Child Protection, particularly in regards to:

• case management responsibilities versus working alongside ASOs in those cases where is a potential child safety issue

• screening all AFSN referrals to see if they were DCP open cases

• ongoing meetings with schools to provide progress updates on children in the AFSN.

The AFSN is actively working in a collaborative manner to resolve these. There have been open discussions about each other’s expectations, and the Family Support Network roles and responsibilities documents will be revised accordingly.

“The role needs to advocate for both DCP and the AFSN.”

- Partner agency



37




There was broad support for the Leader Child Protection to remain at a Team Leader equivalent. This is because it leads to a better interface between the AFSN and DCP. There is mutual respect for each other’s decision making skills, and the Leader Child Protection is able to elevate cases to the DCP Team Leaders quickly and effectively. The Leader Child Protection needs to have the skills and experience to “walk both sides” to decide whether a case should go to the DCP or the AFSN.

Over the 12-month period, there has been a lack of clarity around how DCP and the AFSN will work together, particularly around cases open to DCP, regarding:

• whether a case should remain with DCP or be referred to the AFSN if secondary services are required

• responsibility for overall case management

• scope for co-work and visitations to families.

These issues are being clarified with a series of workshops to be held with Armadale DCP and the CEP to map the above processes and decision making points to ensure all parties have a shared understanding and agreement over how they will work together.

Overall, even with these early “teething” issues, there are early signs of increasing service coordination between the AFSN and DCP and this should improve once processes and decision points have been further clarified and agreed.

Learning:

For future FSNs, the process and role of local CPFS needs to be outlined and agreed prior to the operational beginning of the FSN. This includes:

• agreed process for referrals to the FSN

• agreed process for collaboration on cases

• agreed process for case management (noting that if the service is part of a broader statutory response, then case management remains with CPFS)

• agreed process for any co-work/co-visitation with families.

Case Study: Family Support

A grandmother presented to the Armadale Family Support Network (AFSN) via the Common Entry Point (CEP) as a walk in client after being directed to the AFSN by the Department for Child Protection and Family Support (CPFS). The grandmother presented as distressed and advised that her 21-year-old daughter, who had two young children, had a serious drug dependency. The mother was separated from the children’s father and she lived with the grandmother on an ad hoc basis. However, due to her increasing drug use, incidents of stealing and interaction with alleged drug users, the grandmother had refused to have her daughter

“It’s good to have someone with a lot of background knowledge and thinking about

the way the AFSN works.” - Partner agency



38




reside in the family home, taking over care of the children.

The grandmother advised the CEP that she had previously contacted the Department for Child Protection and Family Support, and had advised them that her daughter was constantly phoning to request money for the children’s nappies and other needs, including the repayment of drug debts; and that on several occasions she had taken the children home with her after finding them looking unkempt and with head lice and scabies. She further advised that drugs were freely available in the house and there were marijuana plants growing outside. She stated that recently her daughter had sought financial support from her as she needed a large sum of money for drug debts and was worried about her physical safety if she did not pay the debt.

The grandmother was provided with ongoing emotional support from the ASO as her daughter was making ongoing demands for money by telephone, during which time she would threaten to come and take the children if she did not receive the money. The ASO encouraged the grandmother to link into counselling, however, the grandmother did not feel ready to do this and requested weekly telephone support from the ASO. Consultations were undertaken with the Leader Child Protection (LCP) to clarify risk issues and ensure that all avenues of support were being explored to help the grandmother. The ASO and LCP also provided support with the:

• the development of a safety plan should the daughter present at their home to remove the children.

• consideration for applying for a VRO against their daughter, which they were granted for two years.

• the provision of a letter of support for childcare, and was also supported throughout the period following the VRO being served.

The ASO continued to support the family for several weeks until the situation de-escalated and the grandmother felt ready to commence counselling with a Partner Agency.

6.2 Stabilisation/reduction in child protection activity The evaluation methodology included a comparison of initial inquiries and Safety and Wellbeing Assessments (SWAs) from comparable districts to the AFSN.22 To achieve this end the AFSN and was matched to districts with similar profiles. The comparison districts were:

• Mirrabooka

• Cannington

• Rockingham

22 Criteria for choosing the appropriate matched districts include that the key characteristics of the districts match those of the AFSN, including, • Number (or proportion) of children aged 0 to 17 years within the district • Number (or proportion) of Indigenous families within the district • Proportion of child protection initial inquiries by district for children aged 0 to 17 years • Proportion of SWAs by district for children aged 0 to 17 years.



39




• Joondalup.

The operating hypothesis is that the AFSN provides an alternative pathway for referrers and that the initial inquiries to the Armadale District of CPFS will be “de-cluttered” of those inappropriate referrals that do not require a statutory response. This should, overtime, lead to CPFS responding to only those referrals that meet the risk threshold, and, in the short term, an increase in SWAs and Orders as CPFS begins to respond only to those children most at risk, and requiring a statutory intervention. Figure 8 details the total number of in scope inquiries across Armadale and the comparison districts, from the third quarter 2009/10 to the third quarter 2012/13.

Figure 8: Total number of in-scope initial inquiries by district

Source: Assist modified by KPMG

While the Armadale District has had an overall increase in initial inquiries from 2009-10 (third quarter) to 2012-13 (third quarter), the analysis highlights across the period that the AFSN has been operating:

• there were 321 initial inquiries during quarter one (Jul-Sep) 2012-13

• decreasing to 265 initial inquiries during quarter two (Oct-Dec) 2012-13

• remaining steady at 266 initial inquiries during quarter three (Jan-Mar) 2012-13.

This has been a 17.1 per cent decrease between quarter one and quarter three. However, the other comparison districts also recorded decreases across the year-to-date – Cannington decreased by 29 per cent, Joondalup by 27 per cent and Mirrabooka by 13 per cent.

The table below highlights the initial inquiries across the five comparison Districts.

0

50

100

150

200

250

300

350

400

Jan-

Mar

Apr-

Jun

Jul-S

ep

Oct

-Dec

Jan-

Mar

Apr-

Jun

Jul-S

ep

Oct

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Table 13: Total in scope inquiries across the districts for quarters 1, 2 and 3 (percent change from previous year)

District 2010-11 2011-12 % change Yr on Yr

2012-13 % change Yr on Yr

Armadale District 611 759 24.2% 852 12.3%

Cannington District 624 844 35.3% 733 -13.2%

Joondalup District 610 495 -18.9% 682 37.8%

Mirrabooka District 633 727 14.8% 666 -8.4%

Rockingham District 325 462 42.2% 723 56.5%

Total 2,803 3,287 17.3% 3,656 11.2%

Source: CPFS data provided to KPMG

The AFSN is beginning to provide an alternative pathway for referrers, however, it is still too early to know whether the AFSN intervention is providing for more appropriate referrals to CPFS Armadale for those requiring statutory response. Preliminary feedback from CPFS Armadale indicates that a decrease in initial inquiries was experienced in terms of activity levels (the decrease), and that it allowed for a better focus on those more appropriate initial inquiries to CPFS.

Finding:

The number of initial inquiries open to CPFS Armadale has been decreasing since quarter one 2012-13 (one month after the AFSN began operating). At this stage it is too early to comment on to what extent this trend is specific to the AFSN or attributable to wider referral patterns to CPFS.

With more appropriate referrals to CPFS there should, in the short-term be an increase in SWAS, particularly substantiated SWAs, as CPFS begins to respond increasingly only to those children most at risk, and requiring a statutory intervention.

Below is an overview of SWAs (both substantiated and not substantiated) across the five comparison districts.



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Figure 9: Total number of commenced in-scope Safety and Wellbeing Assessments by district


This analysis shows that the Armadale District recorded a 44 per cent decrease in SWAs in 2012-13 between quarters one and three. Decreases were recorded in the other districts, as shown in the table below, although Armadale recorded the largest decrease.

Table 14: Total in scope SWAs across the districts for quarters 1, 2 and 3 – 2012/13

District Jul-Sep’12 Oct-Dec’12 Jan-Mar’13 % change over quarters

Armadale District 314 217 175 -44%

Cannington District 174 280 142 -18%

Joondalup District 171 224 111 -35%

Mirrabooka District 176 191 173 -2%

Rockingham District 232 210 151 -35%

Source: CPFS data provided to KPMG

The trend for substantiated SWAs in 2012-13 has also generally trended downward across most Districts, this is outlined below.

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Figure 10: Total number of commenced in-scope Safety and Wellbeing Assessments (substantiated) by district


This analysis shows that the Armadale District recorded a 66 per cent decrease in substantiated SWAs in 2012-13 between quarters one and three. And decreases were recorded in the other districts, as shown in the table below, although Armadale recorded the largest decrease.

Table 15: Total in scope SWAs (substantiated) across the districts for quarters 1, 2 and 3 - 2012/13



Cannington District 31 45 33 6%


Mirrabooka District 58 61 52 -10%


Source: Assist data provided to KPMG

The proportion of SWAs that are substantiated varies markedly between comparison sites. In 2012-13 quarters one, two and three an average of 52.2 per cent of SWAs in Joondalup district were substantiated. In comparison only 15.4 per cent of SWAs in the Armadale district were substantiated.

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Figure 11. Proportion of SWAs substantiated by quarter


The number of SWAs not substantiated for the year 2012-13 have decreased across all Districts – see the Figure below.

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Figure 12: SWAs not substantiated by district

Source: Assist data provided to the Project Team

Armadale has recorded the largest decrease in SWAs for this year compared to all Districts – 39 per cent overall – see the table below for the 2012-13 figures.

Table 16: SWAs (not substantiated) across the districts for quarters 1, 2 and 3



Cannington District 143 235 109 -24%


Mirrabooka District 118 130 121 3%



Prior to the AFSN the trend in SWAs across all Districts was upwards, however, in 2012-13 this was reversed and SWA numbers have decreased substantially. It is too early to tell whether the AFSN is having a positive impact on the CPFS activity levels, although there are signs of early promise with decreases recorded in initial inquiries and SWAs, at a higher rate than other Districts.

Finding:

The trend for initial inquiries is upwards, however Armadale recorded the slowest increase in 2012-13. SWAs have trended downwards across all Districts in financial year 2012-13, with

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Armadale recording the largest decreases in substantiated and non-substantiated SWAs.

6.3 Summary There are early signs of increasing service coordination between the AFSN and CPFS and this should improve once processes and decision points have been further clarified and agreed.

The AFSN is providing an alternative pathway for referrers, however, it is still too early to know whether the AFSN intervention will provide for more appropriate referrals to CPFS Armadale for a statutory response.



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7 Resourcing the AFSN This section outlines the approach adopted for the economic analysis of the AFSN, the results of the analysis, and the overall outcomes delivered for children, families and the community.

7.1 Overview of analytical approach The purpose of the economic analysis is to inform future funding and policy decisions by examining whether the level of investment in the AFSN represents value for money for Government and the community. The analysis focuses on the financial costs and benefits associated with the program, namely the costs incurred by CPFS and service providers in delivering the program, and the future costs to Government that can be avoided as a result of investment in the program (such as reduced CPFS activity).

While the short-term financial benefits of the program, such as the avoided cost of unnecessary CPFS activity are readily quantifiable, many of the longer-term benefits are more difficult to measure and to quantify in monetary terms, and may not be evident during the implementation phase of the AFSN. In addition, for many socio-economic benefits it can also be difficult to attribute causality in relation to the specific contribution of AFSN to longer-term outcomes for children, families and the community as a whole.

To address this issue, existing research, including reports such as The Cost of Child Abuse23 in Australia, informed assumptions to support a high-level quantitative analysis of important socio-economic benefits that arise from the AFSN. These assumptions are clearly detailed and are deliberately conservative to avoid overstating the benefits attributable to Government’s investment in AFSN. Where costs and benefits cannot be quantified, a qualitative commentary towards the assessment is provided.

The analytical approach adopted is consistent with the Australian Government’s Department of Finance’s Handbook of Cost Benefit Analysis, which provides guidance for the conduct of economic analysis for public funded investment in Australia.24

The table below summarises the high-level approach adopted for the cost benefit analysis.

23 Available research includes The Cost of Child Abuse in Australia (Taylor, P., Moore, P., Pezzullo, L., Tucci, J., Goddard, C. and De Bortoli, L., 2008, “The Cost of Child Abuse in Australia”, Australian Childhood Foundation and Child Abuse Prevention Research Australia: Melbourne) produced by the Australian Childhood Foundation and Child Abuse Prevention Research Australia at Monash University. This report identified the economic impact of child abuse, including costs of service provision, lifetime costs and prevention costs. The report found that excluding burden of disease, the one-year cost of child abuse for all children experiencing abuse and neglect in WA was calculated at $397 million. The whole-of-life cost of being abused is $673 million (excluding burden of disease). 24 Department of Finance (2006), Handbook of Cost Benefit Analysis, Financial Management Reference Material No.6



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Table 17: Summary of approach to economic analysis

Analytical step Description / key assumptions

Establishment of the ‘base case’

All costs and benefits must be quantified in terms of their incremental impact compared to what would have occurred in the absence of the intervention (i.e. the ‘base case’). While the implementation and operation of AFSN is likely to have led to a reduction in CPFS activity, the potential decrease in CPFS costs has been incorporated in the analysis as a benefit (i.e. avoided cost) rather than as an additional base case cost.

Identification of cost and benefit components

The analysis quantified the full cost of AFSN over the relevant period (establishment and operating costs over 2011/12 and 2012/13). This included both the costs incurred by CPFS, and additional costs incurred by AFSN lead and partner agencies over the evaluation period (i.e. administrative costs, travel and attendance at meetings, etc).

The analysis consider the contribution of AFSN in terms of a reduction in short term CPFS activity, a reduction in out-of-home care numbers through earlier intervention, and longer-term benefits associated with a reduction in child abuse and neglect such as reduced criminal behaviour, improved education outcomes, and reduced expenditure on health and housing services.

Quantitative assessment of costs and benefits that can be monetised

The following costs and benefits were quantified in monetary terms based on academic literature, and program data obtained from service providers and the Department:

Savings to CPFS through a reduction in inquiries received over the evaluation period due to referral of children and families to AFSN;

Savings to CPFS through a reduction in safety and wellbeing assessments completed during the evaluation period due to referral of children and families to AFSN;

Savings to CPFS through a reduction in future numbers in out-of-home care due to successful intervention via AFSN; and

A reduction in the lifetime costs of child abuse and neglect due to successful intervention via AFSN.

Qualitative assessment of other socio-economic impacts

Policy makers and the academic literature suggest a range of other benefits are likely to be attributable to AFSN, including economic benefits arising from improved employment outcomes, avoided costs to Government and the community from reduced future criminal behaviour, a reduced requirement for housing and health services, etc. These socio-economic impacts have been identified and discussed qualitatively.

Overall value for money assessment

An overall Net Present Value (NPV) for the project was calculated based on the monetised costs and benefits. This was considered to only partially represent the program benefits, with additional unquantifiable benefits attributable to AFSN. Other benefits were assessed qualitatively and considered alongside the quantitative analysis to inform an overall value for money assessment.

Source: KPMG



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The outcomes of the quantitative and qualitative cost benefit analysis are provided below.

7.2 Program cost analysis – results The cost analysis identified two categories of additional expenditure for inclusion in the economic analysis, namely the investment made by CPFS to set up and operate AFSN during the evaluation period, and any additional costs incurred by AFSN lead and partner agencies.

7.2.1 Costs to the Department for Child Protection and Family Support

The table below summarises the actual expenditure by CPFS over the assessment period, including both the establishment and initial operating costs associated with AFSN (costs are expressed in nominal terms).

Table 18: Actual CPFS expenditure

Expenditure 2011/12 2012/13 Total

Salaries $158,858 $312,930 $471,788

Staffing costs $39, 523 $60,145 $99,668

Operating costs $17,250 $21,000 $38,250

Administration $27,000 $49,000 $76,000

Brokerage $- $1,000,000 $1,000,000

Total CPFS expenditure $242,631 $1,443,075 $1,685,706 Source: Department for Child Protection and Family Support

The above includes both funding and brokerage components for AFSN and reflect the first part of a three year contract period running from 1 December 2011 to 30 November 2014. Specifically, each year of the contract period will include $1 million brokerage amount and contract funding of $440,000 (including GST). This service payment will be varied annually in accordance with the Western Australian Government Indexation Policy for the Non-Government Human Services Sector.

In aggregate, CPFS has invested $1.69 million in AFSN over the evaluation period. While this investment has led to a potential reduction in costs that would have otherwise been incurred under a business as usual scenario, these avoided costs have been represented in the analysis as a benefit of Government’s investment in AFSN, rather than a cost attributable to the ‘base case’.

7.2.2 Additional costs to AFSN lead and partner agencies

The implementation of the AFSN has also led to additional costs for the lead and partner agencies separate to the funding provided from CPFS. These include indirect costs resulting from the extra time spent by agencies on administration, attending meetings and setting up processes. It is assumed that the burden on Partner Agencies will reduce as the frequency of meetings decreases, processes become more streamlined and duplication is removed (such as assessments).



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Partner agencies have reported additional indirect costs in the following areas:

• time and resources in maintaining parallel data systems: one for the AFSN and one for the other geographical regions they service

• time spent designing and implementing new processes and procedures in their own organisations as a result of being part of the AFSN

• time spent attending AFSN meetings and travelling to Armadale.

The total number of hours that partner agencies have spent ensuring the implementation and success of the AFSN is 1,242 hours. These time estimates were provided by participating AFSN partner agencies and include the time and effort to travel to and from meetings, develop protocols / documents and other work associated with the AFSN. They represent the best estimate of actual costs rather than a precise calculation.

To calculate the cost impact, the average hourly rate as per the Level 6-3 SACS award has been utilised ($47.26 per hour). Therefore, the average cost impact of the partner agencies involvement is $58,698.

7.2.3 Aggregate cost impact

The table below presents the total additional costs associated with the establishment and operation of AFSN over the evaluation period. Costs are presented in both nominal and Net Present Value (NPV) terms (applying a nominal discount rate of 5 per cent).

Table 19: Aggregate AFSN cost impact Program costs 2011/12 2012/13 Total

CPFS expenditure $242,631 $1,443,075 $1,685,706

Costs incurred by lead and partner agencies - $58,698 $58,698

Overall cost impact (nominal) $242,631 $1,501,773 $1,744,404

Overall cost impact (NPV) $242,631 $1,430,260 $1,672,891

Source: KPMG

The total costs attributable to AFSN over the evaluation period are estimated to be $1.74 million (nominal) or $1.67 million (NPV).

7.3 Quantitative benefits analysis – results The intent of AFSN is to achieve better outcomes for children and families at risk or who are vulnerable, through tailored and coordinated services. Specifically, participation of these children and families in AFSN is expected to lead to avoided costs through a reduction in unnecessary CPFS activity, as well as other cost savings across the broader social services



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sector through a reduction in numbers in out-of-home care and ultimately a decrease in the incidence of child abuse and neglect.

7.3.1 Reduction in CPFS activity

The implementation of AFSN was expected to lead to a reduction in CPFS inquiries and assessments through the referral of children and families to secondary services. To the extent that this reduction has occurred, this would result in an approximate cost saving to CPFS of around $6,458 per case (2010/11 dollars).25

The table below presents the current status of these cases as recorded in FuSioN.

Table 20: Status of AFSN cases

Case status No. of AFSN cases No. of AFSN clients

Case open 218 810

Case completed 149 466

Client Disengaged 100 295

Inappropriate Referral* 50 112

Total AFSN cases 517 1683 Source: FuSioN modified by KPMG *Note: Most of the inappropriate referrals occurred in April 2012 (upon AFSN establishment)

In the absence of AFSN, it is likely that a proportion of the cases that are ongoing, completed or where the client disengaged (477 cases in total) would have led to a CPFS intake and potentially a safety and wellbeing assessment. This may have occurred either at the time of referral to AFSN and may yet still occur for cases being dealt with through the program.

For the purposes of this analysis, it is conservatively estimated that 20 per cent of AFSN cases (excluding inappropriate referrals) would have resulted in a CPFS inquiry and assessment but for the existence of the program. This equates to a total of approximately 100 cases and a total saving of around $640,000 (NPV) over the evaluation period.

7.3.2 Reduced costs out-of-home care

Prior to the implementation of the AFSN, between March 2010 and February 2012, there were a total of 2,209 initial child protection inquiries for children aged 0 to 17 years in the Armadale District, with 6.2 per cent of inquiries leading to child protection orders (138 orders). This means any reduction in inquiries achieved through the implementation of AFSN would be expected to result in a decrease in child protection orders of a similar proportion.

Table 19 below summarises the estimated value of the savings derived from a reduction in the number of children entering out-of-home care.

25 Department for Child Protection, Annual Report 2011-12, p. 50 (estimate of the average cost per case involving a child protection initial inquiry, safety and wellbeing assessment, and / or protection application).



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Table 21: Calculation of avoided cost of out-of-home care Benefit calculation Value Source / assumption

Approximate reduction in inquiries 100 KPMG assumption

Approximate reduction in child protection orders

6 CPFS data provided 2 March 2012

Approximate reduction in out-of-home care numbers

12 FuSioN data modified by KPMG

Average cost per child per day in the CEO’s care $188 CPFS Annual Report 2011/12 (p.5)

Average length of time in the CEO’s care 1,090 days Calculated based on CPFS Annual Report 2011/12 (Table 4, p.11)

Total avoided cost (nominal) $2.46 million Assumed cost evenly distributed across 1090 day period and commencing in 2012/13 Total avoided cost (NPV) $2.23 million

Source: KPMG

Applying the previous assumption that AFSN has conservatively resulted in a reduction in CPFS inquiries of 100 and the historical CPFS data on the proportion of inquiries resulting in child protection orders, it is estimated that AFSN resulted in corresponding decrease in child protection orders of around six. Further, given the average AFSN case relates to three separate clients, this translates to a potential reduction of 18 children entering out-of-home care. For the purposes of this analysis, a reduction of 12 children is assumed, which reflects the fact that not all orders will result in the children entering care.

Based on an average cost per child per day of $188 and an average length of stay in care of 1,090 days (CPFS Annual Report 2011/12 data), this equates to total avoided cost of $2.46 million (nominal) or $2.23 million (NPV). This estimate may understate the true saving as the assumption applied for the average length of time in care relates to a child’s most recent period of care, and does not reflect situations where a child experiences more than one period of care.

7.3.3 Reduced costs of child abuse and neglect

While difficult to quantify, it is generally acknowledged that the consequences and costs associated with child abuse are severe and wide ranging. For example, Taylor et al.26 cite these as: a range of short and long-term physical and mental impacts, later substance misuse, teen pregnancy, debilitated social functioning, evidence of developmental delay and impairment, cognitive and neurological impairment, low academic achievement, delinquency and adult criminal behaviour, subsequent victimisation of their own children, homelessness and premature death. Direct physical outcomes of abuse include abusive head trauma and fractures. Depression, anxiety, post-traumatic stress disorder and borderline personality disorder have all been linked with maltreatment in childhood. 26 Taylor, P., Moore, P., Pezzullo, L., Tucci, J., Goddard, C. and De Bortoli, L., 2008 The Cost of Child Abuse in Australia, Australian Childhood Foundation and Child Abuse Prevention Research Australia: Melbourne and Child Abuse Prevention Research Australia.



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The Australian Childhood Foundation and Child Abuse Prevention Research Australia at Monash University released The Cost of Child Abuse in Australia in 200827. This report identified the economic impact of child abuse, including costs of service provision, lifetime costs and prevention costs. That analysis reflected the following costs associated with child abuse28:

• Health System: costs reflect the short-term costs related to treatment of victims of child abuse and neglect such as physical injuries when a child is hospitalised. Long-term health effects related to child abuse and neglect are mostly related to the child’s mental health and include the health impacts of depression and anxiety disorders as well as suicide29. Numerous studies have been completed and show that utilisation of the health care system is higher for those who have been abused or neglected.

• Education Costs and Productivity losses: Child abuse and neglect have been shown to result in poorer academic performance, greater delinquency and substance abuse, and other behavioural problems that often result in poor labour market outcomes later in life. Education system costs and productivity losses of child abuse and neglect include: cost of interventions required at school to assist those who have experienced abuse or neglect, for example, specialist assistance in regular classes at mainstream schools and through specialist schools; short run production losses due to reduced productivity of victim at work; long-term cost of production due those who have experienced abuse having relatively lower rates of employment; and loss of production resulting from premature death. Unfortunately, there is very little research on the educational attainment or labour market outcomes of children who are maltreated in Australia. There is some evidence that children in out of home care tend to have worse educational outcomes than average where a lack of continuity in placement is a specific risk factor.30

• Crime: the short-term costs of crime correspond to the prosecution of perpetrators through the legal system. These costs include:

- law enforcement

- costs associated with the judicial system – care and protection orders, prosecution of perpetrators and Coroner’s Court proceedings

- incarceration of perpetrators

- victim support – counselling services and intensive family support services.

Long-term costs of crime reflect the second generation impacts of child abuse and neglect such as a higher propensity for those who have been abused to become engaged in a ‘cycle of violence’, with outcomes that include: juvenile delinquency; adult criminality; intergenerational transfer of child abuse and neglect; homelessness; and prostitution. Factors that influence processes leading to second-generation impacts include health

27 Ibid. 28 Ibid. 29 AIHW (2005) Health system expenditure on disease and injury in Australia, 2000-01. Second edition. AIHW cat no. HWE 28 Canberra: AIHW (Health and Welfare). 30 AIHW (2007) Education outcomes of children on guardianship or custody orders: a pilot study. Child Welfare Series no. 42. Cat no. CWS 30. Canberra: AIHW; and Osborne A and Bromfield L (2007) Outcomes for children and young people in care, Australia Institute of Family Studies research brief, No. 3



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outcomes associated with neglect such as mental illness and substance abuse and environmental impacts such as family structure or educational attainment.

• Costs of Protection and Care Programs: expenditure on remedial services that include primary interventions such as support and education before problems arise; secondary interventions such as intensive family support; and tertiary interventions such as care and protection services. Taylor et al. estimate that the cost per child in substantiations of care and protection programs in 2007 was $41,862. The lifetime cost for children newly involved with child protection in 2007 was around $3.0 billion.

• Efficiency losses: losses that occur when money is transferred through the government sector and money needs to be raised through taxation and expenditure incurred through administration of government payments and systems.

• Burden of disease: fear, mental anguish and pain measured in disability adjusted life years. The majority of disease reflects costs of depression and anxiety as well as suicide.

In aggregate, the analysis performed by Taylor et al. estimated the one-year cost in WA of child abuse for all children experiencing abuse and neglect (excluding burden of disease) is $397 million, with an estimated whole-of-life cost of $673 million.31

While there is no estimate provided of the whole-of-life cost per child in WA, a related study in Victoria applying the same methodology estimated a lifetime cost of $175,000 per child. The table below provides an approximate breakdown of the lifetime cost of abuse and neglect over each of the above categories by applying the proportional breakdown in aggregate WA lifetime cost data to the Victorian estimate of the lifetime cost per child.

Table 22: Lifetime cost of child abuse and neglect

Cost component Lifetime cost - best

estimate (WA) Estimated lifetime cost per child (VIC

data) Health $44 million $11,441

Additional education assistance $43 million $11,181

Productivity losses of child abuse survivors $96 million $24,963

Productivity losses due to fatal abuse $11 million $2,860

Crime $55 million $14,302 Government expenditure on care and protection $301 million $78,269

Deadweight losses $123 million $31,984

Total lifetime cost – best estimate (excluding burden of disease)

$673 million $175,000

Total – excluding Government expenditure on care and protection

$372 million $96,731

Source: KPMG

31 Taylor, P., Moore, P., Pezzullo, L., Tucci, J., Goddard, C. and De Bortoli, L., 2008, “The Cost of Child Abuse in Australia”, Australian Childhood Foundation and Child Abuse Prevention Research Australia: Melbourne.



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The above calculation suggests that when the costs of Government expenditure on care and protection are removed (as they are quantified separately above), the lifetime cost of child abuse and neglect in WA is in the order of $95,000 per child.

For the purposes of this analysis, it has been assumed that this cost is partially avoided for children that would otherwise have entered out-of-home care but for their participation in AFSN (i.e. 12 children total). Assuming a 50 per cent reduction in this lifetime cost, this equates to an aggregate saving of approximately $570,000 over the lifetime of the child.

7.3.4 Quantitative benefits analysis

Table 21 below identifies the benefits that have been monetised for inclusion in the quantitative cost benefit analysis and their estimated value in NPV terms. The quantification of these benefits is based on a series of assumptions, which are drawn from academic literature, publicly available data and conservative judgment. The estimates provided should be considered indicative of the magnitude of benefits likely to be derived from AFSN, rather than a definitive or reliable estimate of the return Government should expect from its investment.

Table 23: Summary of monetised benefits associated with AFSN

Benefit Estimated value of benefit (NPV)

Reduction in future CPFS activity $640,000

Reduction in costs of out-of-home care $2,230,000

Reduction in costs of child abuse and neglect $570,000

Total monetised benefits (NPV) $3.44 million

Source: KPMG

As shown above, the total monetised benefits derived from AFSN is estimated to be approximately $3.44 million (NPV). While directly related to the investment made in AFSN during 2011/12 and 2012/13, these benefits will be realised over the lifetime of the children and families participating in the program.

7.4 Qualitative benefits analysis In addition to the above, the literature attributes a range of other economic and social benefits to investment in secondary family support services to assist individuals and families who are at risk or in crisis. The nature and potential scale of these benefits are detailed in the table below.



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Table 24: Qualitative assessment of other impacts derived from AFSN

Benefit category Qualitative assessment

Improved coordination of services via shared IT system and central management of referrals / case allocation

Improved collaboration and information sharing between AFSN providers during the pilot should reduce duplication in terms of assessment and referrals with an overall impact on the average cost per case. Further, use of the FuSion IT system will minimise duplication in data collection as cases are referred and allocated between providers.

Children and families receive services that meet their needs in a more timely manner

The AFSN should generate benefits for children and families through better coordination of services. Improved coordination should: reduce the time that families spend on waiting lists; reduce unnecessary referrals around the system; reduce the need for families to make multiple approaches to different providers in search of assistance; reduce long-term costs associated with families who have become disengaged from the system as a result of their experience.

Second generation benefits Reduction in youth homelessness, juvenile delinquency, adult criminality, intergenerational transfer of child abuse and neglect and prostitution. These impacts are not easily quantified.

Benefits to families AFSN is also expected to result in other benefits such as improved family functioning and improved workforce engagement of family members through participation in the program. This will result in additional lifetime earnings for those family members and a reduction in Government support through welfare and other services.

Source: KPMG

These benefits are additional to those quantified above, which suggests the actual benefits associated with AFSN are likely to be substantially greater than the estimated $3.44 million.

7.5 Economic analysis – overall conclusions The table below summarises the overall outcomes of the quantitative cost benefit analysis.

Table 25: Quantitative cost benefit analysis outputs – aggregate impacts

Item NPV

Approximate value of additional costs to Government $1.67 million

Approximate value of benefits derived from investment $3.44 million

Net quantitative benefit / (cost) $1.77 million

Benefit cost ratio 2.06

Source: KPMG



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In summary, the analysis presented in this section demonstrates that the benefits resulting from participation AFSN are likely to significantly outweigh the costs associated with the program. This is evidenced by the results of the quantitative analysis, which although excluding significant benefits that were not able to be quantified, still shows a substantial net benefit resulting from the Government’s investment in the program.

Below summarises the estimated costs and benefits per child participating in AFSN.

Table 26: Quantitative cost benefit analysis outputs – estimated impact per child

Item Cost / benefit per client

Approximate cost per client participating in AFSN $992 per client

Approximate benefit per client participating in AFSN $2,044 per client

Net benefit / (cost) per child $1,052 per client

Source: KPMG

In aggregate, it is estimated that for every dollar invested to support the participation of children and families in AFSN, the Western Australian Government and the community will save at least $2.06 in reduced expenditure on future CPFS activities, out-of-home care, and avoided lifetime cost of child abuse and neglect. This equates to a net benefit of around $1,052 per AFSN client participating in the program.

7.6 Sensitivity testing This section examines the sensitivity of the above analysis to variations in key assumptions underpinning the quantitative benefits analysis. This reflects the inherent uncertainty in attributing longer term or whole of life outcomes to the participation of children and families in AFSN over the evaluation period.

Table 27 below describes the alternative assumptions applied as part of the sensitivity analysis. These alternative assumptions were applied both individually and collectively to evaluate their impact on the outcomes of the analysis.

Table 27: Sensitivity analysis Variable Current assumption Sensitivity assumptions

Reduction in CPFS inquiries and assessments

20 per cent of AFSN cases would otherwise have resulted in CPFS activity.

10 per cent of AFSN cases would otherwise have resulted in CPFS activity.

Reduction in numbers in out-of-home care

AFSN assumed to result in a reduction of 12 in future out-of-home care numbers.

AFSN assumed to result in a reduction of six in future out-of-home care numbers.

Reduction in child abuse and neglect

AFSN assumed to contribute to a 50% reduction in lifetime costs of child abuse and neglect for 12 children.

AFSN assumed to contribute to a 50% reduction in lifetime costs of child abuse and neglect for 6 children.

The outcome of the above sensitivity analysis is summarised in Table 28, below, with the impact of each on the assessed level of quantitative costs and benefits provided.



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Table 28: Outcomes of the sensitivity analysis (NPV, 2011 dollars)

Sensitivity outcomes Net Present Value (2011 dollars)

Total Costs Total Benefits Net Benefit / (Cost)

Reduction in CPFS inquiries and assessments $1.67 million $3.11 million $1.44 million

Reduction in numbers in out-of-home care $1.67 million $2.30 million $0.63 million

Reduction in costs of child abuse and neglect $1.67 million $3.13 million $1.46 million

All of the above $1.67 million $1.71 million $0.04 million

As shown above, under all sensitivity scenarios the quantitative benefits estimated for AFSN remain greater than the cost impacts. If all alternative assumptions are applied simultaneously the estimated quantitative benefits are approximately equal to the total costs. However, taking into account the qualitative impacts identified above, the program benefits would still exceed the program costs.



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A Stakeholders The following stakeholders were consulted in preparing this report.

Table 29: Stakeholders consulted

Organisation Name Title

Department for Child Protection and Family Support

Department for Child Protection and Family Support

Julie Dixon Director Individual and Family Support

Misty Hayden Senior Policy and Program Officer

Rosemary Bradbury Manager Non-Government Funding and Contracts

Matt McGerr Senior Contracts and Grants Manager

Department for Child Protection and Family Support – Armadale District

Robert Becker District Director

Sue Looby Leader Child Protection

Rory Cornelius Team Leader

Eileen Cooper Team Leader

Stacey McAlister Senior Practice Development Officer

AFSN lead agency

Parkerville Children and Youth Care (Inc)

Natalie Hall Director Child Advocacy Centre

Kathleen Parker Alliance Manager

Kris Gorbert Assessment Support Officer

Vicci Greensmith Assessment Support Officer

Teena Keane - Hogan Assessment Support Officer

AFSN partner agencies

Armadale Youth Resources Denise Hardie Metropolitan Manager



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Centrecare Jason Thompson A/Executive Manager

Kate Ihanimo A/Program Manager

Coolabaroo Lisa Rutherford Manager Housing Services

Djooraminda Centrecare Liz Magee Team Leader Intensive Family Support Services

Drug ARM Lee Lombardi Executive Manager Services

Mission Australia Peter Osborn Service Manager

Minnawarra House Jillian Betts Community Development Officer

Sandra-Ruby Angel Chief Executive Officer

Parkerville Therapeutic Family Services

Nina Formentin Psychologist

Relationships Australia Carol Linton Rudd Branch Manager Gosnells

Fiona Halse Counsellor

Ruah Support Services Penny Tucker Ruah Inreach Armadale Team Manager

Amanda Horlin Community Mental Health Worker

Starick Services Arina Aoina Chief Executive Officer

Wanslea Pauline Dixon Executive Manager Family Services

Peta Hart Operational Manager

Manika Goel Social Worker

Diane Smith Senior Social Worker

Other stakeholders

Armadale Domestic Violence Angie Wragg Coordinator



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Intervention ProjectEdna Riley Coordinator

Armadale Hospital Seremonde Hobby Emergency Department Social Worker

Ashburton Drive Primary School Paige Jones Deputy Principal

Bletchley Park Primary School Josie Millwood Deputy Principal

Challis Primary School Louise O’Donovan Deputy Principal

Child Adolescent Mental Health Services

Jason Ellis Service Manager

City of Armadale Rebekah Milnes Coordinator Community Development Team

Clifton Hills Primary School Trish Dellafranca Deputy Principal / Learning Support Coordinator

Source: KPMG

Documents

ABCD - Western Australian Family Support Networks€¦ · 3 The Armadale Family Support Network 15 3.1 The Armadale district 15 3.2 Overview of the Armadale Family Support Network